Stacie Dawn Fenderson, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

52724 Issued in CA

Practice address

8689 Folsom Blvd
Sacramento, CA 95826

Phone

(916) 381-7171

Fax

(916) 381-1171

NPI assigned

Oct 17, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1053500959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MEADOW GATE RD",
            "city": "MEADOW VISTA",
            "state": "CA",
            "postal_code": "95722",
            "telephone_number": "916-381-7171",
            "fax_number": "530-878-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8689 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95826",
            "telephone_number": "916-381-7171",
            "fax_number": "916-381-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDERSON",
        "first_name": "STACIE",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "52724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Elena Felt
• Sadie Michelle Felton
• Denise Claudette Feltus
• Wanda Feltus
• Sarah Fender, RN, NP-C
• Angela Feng
• Zhaolin-Emily Feng
• Sherra Zade Feniuck
• Richard Matthew Fenner III, MD
• Jesse Fenton, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.